The present invention relates to new N-substituted benzoyl indole compounds which are useful as estrogenic agents, as well as pharmaceutical compositions and methods of treatment utilizing these compounds.
Estrogen replacement therapy has been well established as the treatment of choice in women for the prevention of osteoporosis. [C. Christiansen, R. Lindsay, Estrogen, Bone Loss and Preservation, Osteoporosis International, 1, 15-21 (1990)] The downside to this therapy is that when estrogen is given alone i.e. without the opposing effects of progestins, proliferative effects on the uterus may result and thereby can put the patient at risk for endometrial cancer. Although less clear, hormone replacement therapy has been implicated in increasing the incidence of breast tumor formation. Non-steroidal antiestrogen drugs such as tamoxifen have been used in the treatment of breast cancer. The drug also is known to maintain bone mass, acting as a bone-sparing estrogen agonist, however it is also an agonist in uterine tissue. A more recent antiestrogen drug, Lilly""s raloxifene, is a non-steroidal antiestrogen which appears to be more tissue selective. While having the desirable property of sparing bone, it has been demonstrated to stimulate uterine growth in animal models to a lesser degree than tamoxifen. Additionally, recent clinical data reveal no endometrial hyperplasia. A review on the tissue selective action of estrogen analogs has recently appeared. [G. L. Evans and R. T. Turner, Tissue Selective Actions of Estrogen Analogs, Bone, 17, no. 4, 1815-1905 (1995)].
The use of indoles as estrogen antagonists has been reported by Von Angerer, Chemical Abstracts, Vol. 99, No. 7 (1983), Abstract No. 53886u. Also, see, J. Med. Chem. 1990, 33, 2635-2640; J. Med. Chem. 1987, 30, 131-136. Also see Ger. Offen., DE 3821148 A1 891228 and WO 96/03375. These prior art compounds share some structural similarities with the present compounds, but are functionally different. For compounds containing a basic amine, there is no phenyl group to ridgidify the side chain. The reported data for these compounds indicates that they may have a weaker binding to estrogen receptor than the compounds of the present invention and the basic side chain containing compounds show some uterotrophic effect in the rat uterus.
WO A 95 17383 (Kar Bio AB) describes indole antiestrogens with long straight chains. Another related patent WO A 93 10741 describes 5-hydroxyindole with a generic descriptor incorporating other side chains.
U.S. Pat. No. 5,496,844 (Inai, et al.) teaches substituted N-indole compounds having potent antiestrogenic activity which are useful in the treatment of estrogen-dependent diseases, such as anovulatory infertility, prostatic hypertrophy, osteoporosis, breast cancer, endometrial cancer and melanoma.
Jones et al., in their article Antiestrogens. 2.1 Structure-Activity Studies in a Series of 3-Aroyl-2-arylbenzo[b]thiophene Derivatives Leading to [6-Hydroxy-2-(4-hydroxyphenyl)benzo[b] thien-3-yl][4-[2-(1-piperidinyl)ethoxy]phenyl]methanone Hydrochloride (LY156758), a Remarkably Effective Estrogen Antagonist with Only Minimal Intrinsic Estrogenicity, J. Med. Chem. 1984, 27, 1057-1066, disclose a series of 3-aroyl-2-arylbenzo[b]thiophene derivatives which act as non-steroidal antiestrogens.
The compounds described in the present invention are mixed estrogen agonists/antagonists and have potential use in treating osteoporosis, endometriosis, prostatic hypertrophy, breast cancer and endometrial cancer.
The present invention provides N-substituted indoles of Formula (I): 
wherein
R1, R2 and R3 are independently selected from hydrogen, C1-C6 alkyl, C1-C6 alkoxy, xe2x80x94CF3, xe2x80x94NO2, cyano, C1-C6 alkyl (straight chain or branched), trifluoromethyl, xe2x80x94OH or the C1-C12 esters (straight chain or branched) or C1-C12 alkyl ethers (straight chain or branched or cyclic) thereof, halogens, or C1-C6 halogenated ethers, preferably C1-C3 halogenated ethers, including trifluoromethyl ether and trichloromethyl ether;
R4 and R5 are independently selected from H or benzyl, the benzyl group being optionally substituted by C1-C6 alkyl, C1-C6 alkoxy, xe2x80x94CF3, or halogen;
X is H, C1-C6 alkyl, or CF3;
Z is O or S;
n is 2 or 3;
Y is selected from:
a) a moiety of the formula: 
xe2x80x83wherein Rxe2x80x2 is C1-C6 lower alkyl; or
b) a moiety selected from the group of: 
or a pharmaceutically acceptable salt thereof.
A preferred group of this invention are those compounds of Formula I wherein R1, R2 and R3 are independently selected from hydrogen, C1-C6 alkyl, C1-C6 alkoxy, xe2x80x94CF3, or xe2x80x94NO2; and R4, R5, X, Z, n, and Y are as defined above, or a pharmaceutically acceptable salt thereof.
Another preferred group of compounds of this invention are those in which Z is oxygen and R1, R2, R3, R4 and R5 are H, or a pharmaceutically acceptable salt thereof. Among the most preferred compounds of these generic and subgeneric groups are those in which Y is a piperidine ring.
This invention includes acceptable salt forms formed from the addition reaction with either inorganic or organic acids. Inorganic acids such as hydrochloric acid, hydrobromic acid, hydroiodic acid, sulfuric acid, phosphoric acid, nitric acid as well as organic acids such as acetic acid, propionic acid, citric acid, maleic acid, malic acid, tartaric acid, phthalic acid, succinic acid, methanesulfonic acid, toluenesulfonic acid, napthalenesulfonic acid, camphorsulfonic acid, benzenesulfonic acid are useful. Among the preferred salts of the compounds herein are the HCl, HBr, and acetate salts.
The compounds of the invention are partial estrogen agonists and display high affinity for the estrogen receptor. Unlike many estrogens, however, many of these compounds do not cause the increases in uterine wet weight normally associated with natural or synthetic estrogens. These compounds are antiestrogenic in the uterus and antagonize the trophic effects of estrogen agonists in uterine tissue. In addition, the compounds may be used as estrogen agonists in bone tissue. Due to the tissue selective nature of these compounds, they are useful in treating or preventing in a mammal disease states or syndromes which are caused or associated with an estrogen deficiency or an excess of estrogen.
The present compounds have the ability to behave like estrogen agonists by lowering cholesterol and preventing bone loss. These compounds are useful for treating many maladies which result from estrogen excess or deficiency including osteoporosis, prostatic hypertrophy, male pattern baldness, ovarian cancer, infertility, breast cancer, endometrial cancer, cardiovascular disease, contraception, Alzheimer""s disease, cognitive decline and other CNS disorders, as well as certain cancers, including melanoma, prostrate cancer, cancers of the colon, CNS cancers, among others. Additionally, these compounds can be used for hormone replacement therapy in post-menopausal women or in other estrogen deficiency states where estrogen supplementation would be beneficial.
The compounds of this invention may also be used in methods of treatment for bone loss, which may result from an imbalance in an individual""s formation of new bone tissues and the resorption of older tissues, leading to a net loss of bone. Such bone depletion results in a range of individuals, particularly in post-menopausal women, women who have undergone hysterectomy, those receiving or who have received extended corticosteroid therapies, those experiencing gonadal dysgenesis, and those suffering from Cushing""s syndrome. Special needs for bone replacement can also be addressed using these compounds in individuals with bone fractures, defective bone structures, and those receiving bone-related surgeries and/or the implantation of prosthesis. In addition to those problems described above, these compounds can be used in treatments for osteoarthritis, hypocalcemia, hypercalcemia, Paget""s disease, osteomalacia, osteohalisteresis, multiple myeloma and other forms of cancer having deleterious effects on bone tissues. Methods of treating the maladies listed herein are understood to comprise administering to an individual in need of such treatment a pharmaceutically effective amount of one or more of the compounds of this invention or a pharmaceutically acceptable salt thereof. This invention also includes pharmaceutical compositions utilizing one or more of the present compounds, and/or the pharmaceutically acceptable salts thereof, along with one or more pharmaceutically acceptable carriers, excipients, etc.
It is understood that the dosage, regimen and mode of administration of these compounds will vary according to the malady and the individual being treated and will be subject to the judgement of the medical practitioner involved. It is preferred that the administration of one or more of the compounds herein begin at a low dose and be increased until the desired effects are achieved.
Effective administration of these compounds may be given at an effective dose of from about 0.1 mg/day to about 1,000 mg/day. Preferably, administration will be from about 10 mg/day to about 600 mg/day in a single dose or in two or more divided doses. Such doses may be administered in any manner useful in directing the active compounds herein to the recipient""s bloodstream, including orally, parenterally (including intravenous, intraperitoneal and subcutaneous injections), and transdermally. For the purposes of this disclosure, transdermal administrations are understood to include all administrations across the surface of the body and the inner linings of bodily passages including epithelial and mucosal tissues. Such administrations may be carried out using the present compounds, or pharmaceutically acceptable salts thereof, in lotions, creams, foams, patches, suspensions, solutions, and suppositories (rectal and vaginal).
Oral formulations containing the active compounds of this invention may comprise any conventionally used oral forms, including tablets, capsules, buccal forms, troches, lozenges and oral liquids, suspensions or solutions. Capsules may contain mixtures of the active compound(s) with inert fillers and/or diluents such as the pharmaceutically acceptable starches (e.g. corn, potato or tapioca starch), sugars, artificial sweetening agents, powdered celluloses, such as crystalline and microcrystalline celluloses, flours, gelatins, gums, etc. Useful tablet formulations may be made by conventional compression, wet granulation or dry granulation methods and utilize pharmaceutically acceptable diluents, binding agents, lubricants, disintegrants, suspending or stabilizing agents, including, but not limited to, magnesium stearate, stearic acid, talc, sodium lauryl sulfate, microcrystalline cellulose, carboxymethylcellulose calcium, polyvinylpyrrolidone, gelatin, alginic acid, acacia gum, xanthan gum, sodium citrate, complex silicates, calcium carbonate, glycine, dextrin, sucrose, sorbitol, dicalcium phosphate, calcium sulfate, lactose, kaolin, mannitol, sodium chloride, talc, dry starches and powdered sugar. Oral formulations herein may utilize standard delay or time release formulations to alter the absorption of the active compound(s). Suppository formulations may be made from traditional materials, including cocoa butter, with or without the addition of waxes to alter the suppository""s melting point, and glycerin. Water soluble suppository bases, such as polyethylene glycols of various molecular weights, may also be used.
Compounds of this invention may be prepared by methods known in the art. For instance, the starting or core indole can be prepared by the general method of Scheme 1, below. 
The initial indole synthesis for 5-Benzyloxy-2-(4-benzyloxy-phenyl)-3-methyl-1H-indole is accomplished by heating an appropriately substituted alpha-bromo ketone (b) with the desired aniline (a) in DMF to form the indole (c). The (aminoethoxy)benzoic acid side chains of the present compounds may be prepared by the general methods taught by Jones et al., J. Med. Chem., 1984, Vol. 27, No. 8, pp. 1057-1066 or as shown in Scheme 2 and coupled to the core indoles via the method of Scheme 3. 